|
|
Minimally-invasive approaches for the hip replacements
Kubeš, Radovan ; Koudela, Karel (advisor) ; Poul, Jan (referee) ; Landor, Ivan (referee)
Contemporary world and medicine are marked by very rapid development of miniaturization, which surprisingly not missed also endoprothetics and arised thankfully to the strong medial attention gigantic wave of public interest about possibility of mini - invasive operative. In public media was this method presented like revolutionary and almost like a nonstrum, first medical publications (especially from pioneers those techniques) were also generally positive, but also since the begginnig had this method also its non-supporters. Own idea of mini- invasive operative is without any doubt correct step into the future, theoretical benefits are indisputable and logical. In wiew of this facts, that it was for me "no man's land" , I decided as a first step to study all published facts and later than I began practical testing of mini-invasive approaches on cadavers studies and than finally after very carefully evaluation of all facts I started to perform mini-invasive approaches. In an effort to deprese maximally the learnig curve, I started my mini-invasive implantation with femoral component only - so cervicocapital endoprosthesis, only after estimation of this group and with newly acquired experiences I came up to perform MIS- THR .. Our statistically prooved final results tell us, that implantation THR...
|
|
|
Biological characteristics of orthopaedic implant surfaces
Ballay, Rastislav ; Landor, Ivan (advisor) ; Džupa, Valér (referee) ; Gallo, Jiří (referee)
Total hip and knee arthroplasty surgeries form an integral part of orthopaedic practice. With an increase of the primary arthroplasty surgeries performed, comes also an increase in the number of complications. The most common complications of these otherwise very successful procedures is periprosthetic joint infections which are also one of the most difficult to treat. In the first part of the study, we evaluated the primary bacterial resistance of the 14 most commonly used materials in the construction of joint prostheses. More specifically, we concentrated on how their surface treatment resists colonisation by specific bacterial species (Staphylococcus aureus, Staphylococcus epidermidis, Pseudomonas aeruginosa, Enterococcus faecalis and Escherichia coli). The studied materials included metal alloys that are commonly used in the weight bearing parts of implants - CoCrNo, FeNiCr and Ti6A14V - but also polymeric and ceramic materials used in the bearing materials, represented by ultra-high- molecular-weight polyethylene (UHMWPE) and aluminium oxide (Al2O3). Our aim was to assess the relationship between material surface roughness and the sensitivity to colonisation by specific bacterial strains and to evaluate their affinity to different materials. Previous studies have proven that the roughness of...
|
|
|
New Surgical Techniques to Prevent Serious Permanent Disability of Proximal Hume ral Fractures
Edelmann, Karel ; Čelko, Alexander (advisor) ; Janout, Vladimír (referee) ; Landor, Ivan (referee)
NEW SURGICAL TECHNIQUES TO PREVENT SERIOUS PERMANENT DISABILITY OF PROXIMAL HUMERAL FRACTURES AIM: Fractures of the proximal humerus are the third most common fracture in adults. In the treatment of displaced three-and four-part fractures in the last decade we have witnessed the advent of new angular stable implants, which have better biomechanical stability in osteoporotic bone in these patients very frequent. The purpose of this study was to determine whether these new implants are a better prevention of severe permanent disability, compared with the earlier technique of percutaneous pinning with K wires. METHOD: The detailed analysis for publishing rich area of research literature on treatment history, epidemiology and prevention of proximal humerus fractures was accomplished. Medium-term results were evaluated in a prospective randomized study of 55 patients treated with angular stable implants with an average age of 62.1 years (Targon PH nail 32 patients, Philos plate 23 patients). For comparison was used a group of 9 patients treated with percutaneous K wire fixation, combined monitored prospectively and retrospectively. With a minimal follow up of 12 months in all patients was determined the final individual relative Constant score and DASH score. For patients in the sample were obtained...
|
|
|
The Impact of the Mechanical Dependence of the Components of Total Elbow Replacement on Implant Survivorship
Güttler, Kristián ; Landor, Ivan (advisor) ; Koudela, Karel (referee) ; Džupa, Valér (referee)
Drawing on long-term clinical experience, the dissertation provides an overview of the options for the reconstructive surgery of irreversibly damaged elbow joints and the individual structural directions in the development of total elbow replacements. The clinical study focuses on the comparison of the unconstrained Souter-Strathclyde elbow implant, which has been used at our workplace since 1987, and the semiconstrained Coonrad-Morrey implant, which we started to use in the nineties. The disadvantages of the Souter-Strathclyde implant consist of a relatively complex surgery technique and narrower indication which does not permit larger primary instability of the operated elbow and large bone defects. Due to these reasons in recent years the Coonrad-Morrey total elbow replacement has been the preferred option at our workplace. The main problem as regards the long-term survival of this implant is especially the wear of the polyethylene bushings of the fl oppy hinge. This can be solved through an early replacement of this hinge before substantial abrasive wear develops ultimately leading to the loosening of the whole implant. We have elaborated a methodology that maps the condition of the polyethylene bushings and at the same time examines the integration of the humeral and ulnar component in the...
|
|
|
Establishing optimal indications for distal radius fractures, based on fracture type, and comparison of the outcomes of clinical evaluation with mathematical modeling
Vlček, Martin ; Landor, Ivan (advisor) ; Džupa, Valér (referee) ; Koudela, Karel (referee)
Distal radius fractures are the most common types of break to the arm bones. Conservative treatment in unstable fracture types cannot guarantee healing of the bones in a correct anatomical position. Locking plate osteosynthesis is at present regarded as the method of choice in surgical treatment of all types of distal radius fractures. An issue to be solved concerns the role for intramedullary implants in these indications. The aim of our study was to find the optimal indication for each of the osteosynthesis method currently used in distal radius fractures. We evaluated the one-year results of treatment for distal radius fractures. The group evaluated comprised 49 conservatively treated fractures, 78 fractures treated by angle-stable locking plates with either rigiddirection or multidirectional screws and 35 fractures in which Targon DR intramedullary nails or X-screws were used. Some radiographic parameters were better in the patients treated by intramedullary osteosynthesis, while some of the functional outcomes were better in the fractures treated by plate osteosynthesis although this method was indicated in patients with significantly more complicated fractures. A mathematical model was used to simulate distal radius fractures, type C1 and type C2. The stability of both locking plate and intramedullary...
|
|
|
New Surgical Techniques to Prevent Serious Permanent Disability of Proximal Hume ral Fractures
Edelmann, Karel ; Čelko, Alexander (advisor) ; Janout, Vladimír (referee) ; Landor, Ivan (referee)
NEW SURGICAL TECHNIQUES TO PREVENT SERIOUS PERMANENT DISABILITY OF PROXIMAL HUMERAL FRACTURES AIM: Fractures of the proximal humerus are the third most common fracture in adults. In the treatment of displaced three-and four-part fractures in the last decade we have witnessed the advent of new angular stable implants, which have better biomechanical stability in osteoporotic bone in these patients very frequent. The purpose of this study was to determine whether these new implants are a better prevention of severe permanent disability, compared with the earlier technique of percutaneous pinning with K wires. METHOD: The detailed analysis for publishing rich area of research literature on treatment history, epidemiology and prevention of proximal humerus fractures was accomplished. Medium-term results were evaluated in a prospective randomized study of 55 patients treated with angular stable implants with an average age of 62.1 years (Targon PH nail 32 patients, Philos plate 23 patients). For comparison was used a group of 9 patients treated with percutaneous K wire fixation, combined monitored prospectively and retrospectively. With a minimal follow up of 12 months in all patients was determined the final individual relative Constant score and DASH score. For patients in the sample were obtained...
|
|
|
The Impact of the Mechanical Dependence of the Components of Total Elbow Replacement on Implant Survivorship
Güttler, Kristián ; Landor, Ivan (advisor) ; Koudela, Karel (referee) ; Džupa, Valér (referee)
Drawing on long-term clinical experience, the dissertation provides an overview of the options for the reconstructive surgery of irreversibly damaged elbow joints and the individual structural directions in the development of total elbow replacements. The clinical study focuses on the comparison of the unconstrained Souter-Strathclyde elbow implant, which has been used at our workplace since 1987, and the semiconstrained Coonrad-Morrey implant, which we started to use in the nineties. The disadvantages of the Souter-Strathclyde implant consist of a relatively complex surgery technique and narrower indication which does not permit larger primary instability of the operated elbow and large bone defects. Due to these reasons in recent years the Coonrad-Morrey total elbow replacement has been the preferred option at our workplace. The main problem as regards the long-term survival of this implant is especially the wear of the polyethylene bushings of the fl oppy hinge. This can be solved through an early replacement of this hinge before substantial abrasive wear develops ultimately leading to the loosening of the whole implant. We have elaborated a methodology that maps the condition of the polyethylene bushings and at the same time examines the integration of the humeral and ulnar component in the...
|
|
|
Minimally-invasive approaches for the hip replacements
Kubeš, Radovan ; Koudela, Karel (advisor) ; Poul, Jan (referee) ; Landor, Ivan (referee)
Contemporary world and medicine are marked by very rapid development of miniaturization, which surprisingly not missed also endoprothetics and arised thankfully to the strong medial attention gigantic wave of public interest about possibility of mini - invasive operative. In public media was this method presented like revolutionary and almost like a nonstrum, first medical publications (especially from pioneers those techniques) were also generally positive, but also since the begginnig had this method also its non-supporters. Own idea of mini- invasive operative is without any doubt correct step into the future, theoretical benefits are indisputable and logical. In wiew of this facts, that it was for me "no man's land" , I decided as a first step to study all published facts and later than I began practical testing of mini-invasive approaches on cadavers studies and than finally after very carefully evaluation of all facts I started to perform mini-invasive approaches. In an effort to deprese maximally the learnig curve, I started my mini-invasive implantation with femoral component only - so cervicocapital endoprosthesis, only after estimation of this group and with newly acquired experiences I came up to perform MIS- THR .. Our statistically prooved final results tell us, that implantation THR...
|
guest ::
